Healthcare Provider Details

I. General information

NPI: 1104138007
Provider Name (Legal Business Name): WINSTON HARPER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PORTSMOUTH AVE # 1109
STRATHAM NH
03885-6528
US

IV. Provider business mailing address

700 MOUNT HOPE AVE STE 620
BANGOR ME
04401-5671
US

V. Phone/Fax

Practice location:
  • Phone: 603-377-1747
  • Fax: 603-377-1747
Mailing address:
  • Phone: 207-947-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1248
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD1098
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0391
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: